S53.422S - Ulnohumeral (joint) sprain of left elbow, sequela
| ICD-10: | S53.422S |
| Short Description: | Ulnohumeral (joint) sprain of left elbow, sequela |
| Long Description: | Ulnohumeral (joint) sprain of left elbow, sequela |
| Status: | Valid for Submission |
| Version: | ICD-10-CM 2023 |
| Code Classification: |
S53.422S is a billable ICD-10 code used to specify a medical diagnosis of ulnohumeral (joint) sprain of left elbow, sequela. The code is valid during the fiscal year 2023 from October 01, 2022 through September 30, 2023 for the submission of HIPAA-covered transactions. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
S53.422S is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like ulnohumeral (joint) sprain of left elbow. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.
Coding Guidelines
The appropriate 7th character is to be added to each code from block Dislocation and sprain of joints and ligaments of elbow (S53). Use the following options for the aplicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Present on Admission (POA)
S53.422S is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
| POA Indicator Code | POA Reason for Code | CMS will pay the CC/MCC DRG? |
|---|---|---|
| Y | Diagnosis was present at time of inpatient admission. | YES |
| N | Diagnosis was not present at time of inpatient admission. | NO |
| U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
| W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
| 1 | Unreported/Not used - Exempt from POA reporting. | NO |
Convert to ICD-9 Code
| Source ICD-10 Code | Target ICD-9 Code | |
|---|---|---|
| S53.422S | 905.7 - Late effec sprain/strain | |
| Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code. | ||
Patient Education
Elbow Injuries and Disorders
Your elbow joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the elbow joint move. When any of these structures is hurt or diseased, you have elbow problems.
Many things can make your elbow hurt. A common cause is tendinitis, an inflammation or injury to the tendons that attach muscle to bone. Tendinitis of the elbow is a sports injury, often from playing tennis or golf. You may also get tendinitis from overuse of the elbow.
Other causes of elbow pain include sprains and strains, fractures (broken bones), dislocations, bursitis, and arthritis. Treatment depends on the cause.
[Learn More in MedlinePlus]
Sprains and Strains
A sprain is a stretched or torn ligament. Ligaments are tissues that connect bones at a joint. Falling, twisting, or getting hit can all cause a sprain. Ankle and wrist sprains are common. Symptoms include pain, swelling, bruising, and being unable to move your joint. You might feel a pop or tear when the injury happens.
A strain is a stretched or torn muscle or tendon. Tendons are tissues that connect muscle to bone. Twisting or pulling these tissues can cause a strain. Strains can happen suddenly or develop over time. Back and hamstring muscle strains are common. Many people get strains playing sports. Symptoms include pain, muscle spasms, swelling, and trouble moving the muscle.
At first, treatment of both sprains and strains usually involves resting the injured area, icing it, wearing a bandage or device that compresses the area, and medicines. Later treatment might include exercise and physical therapy.
NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
[Learn More in MedlinePlus]
Code History
- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)